Short-term clinical results of revision anterior cruciate ligament reconstruction – double-bundle hamstrings graft vs. rectangular bone-patellar tendon-bone Graft

Abstract

The purpose of this study was to compare short-term clinical result of revision ACL reconstruction (ACLR) using double-bundle hamstrings grafts (DB-HT) with that of ACLR using rectangular BTB graft (RT-BTB). Thirty-one patients (11 males and 20 females, mean age 21.7 years) were included in this study. Sixteen patients (primary graft: HT in 9, BTB in 7 patients) underwent revision ACLR with double-bundle technique using HT graft (DB-HT group), 15 patients (primary graft: ITB in 1, HT in 14 patients) underwent revision with rectangular tunnel using BTB grafts (RT-BTB group). All patients were evaluated for knee stability, muscle strength recovery of the knee, the Tegner activity score and the Knee injury and Osteoarthritis Outcome Score (KOOS) with a mean follow-up of 32.5 months (range, 24–61 months). One patient in DB-HT group had ipsilateral re-injury. One patient in the RT-BTB group had contralateral ACL injury. Side-to-side differences of anterior stability with KT-1000 were 0.8 ± 0.8 mm in DB-HT group and 0.8 ± 0.9 mm in RT-BTB group at final follow-up. Positive pivot shift rate in DB-HT group (35.7%) was higher than that in RT-BTB group (13.3%). There was no difference in muscle strength recovery, the Tegner activity score and KOOS subscores between the two groups. Multiple regression analysis revealed that femoral tunnel malposition and not graft selection was significantly associated with KOOS in revision surgery. Positive rate of pivot shift in the DB-HT group was higher than in the RT-BTB group. However, graft choice in revision surgery did not affect subjective outcomes.